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Standardising Dementia Diagnosis Across Linguistic and Educational Diversity: Study Design of the Indian Council of Medical Research-Neurocognitive Tool Box (ICMR-NCTB)

Published online by Cambridge University Press:  12 December 2019

Gowri K. Iyer
Affiliation:
Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India Indian Institute of Public Health, Hyderabad 500033, India
Avanthi Paplikar
Affiliation:
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
Suvarna Alladi*
Affiliation:
Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
Aparna Dutt
Affiliation:
Apollo Gleneagles Hospital, Cognitive Neurology Unit, Kolkata 700097, India Duttanagar Mental Health Centre, Neuropsychology & Clinical Psychology Unit, Duttanagar, Kolkata 700077, India
Meenakshi Sharma
Affiliation:
Indian Council of Medical Research, New Delhi 110029, India
Shailaja Mekala
Affiliation:
Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany
Subhash Kaul
Affiliation:
Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India Department of Neurology, Krishna Institute of Medical Sciences, Hyderabad 500082, India
Aralikatte Onkarappa Saroja
Affiliation:
Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belgaum 590010, India
Gollahalli Divyaraj
Affiliation:
Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India
Ratnavalli Ellajosyula
Affiliation:
Department of Neurology, Manipal Hospitals, Bengaluru 560071, India
Amitabha Ghosh
Affiliation:
Apollo Gleneagles Hospital, Cognitive Neurology Unit, Kolkata 700097, India
Roopa Hooda
Affiliation:
Neurosciences Center, All India Institute of Medical Sciences, Delhi 110023, India
Sunita Justus
Affiliation:
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, India
Rajmohan Kandukuri
Affiliation:
Department of Neurology, Nizam’s Institute of Medical Sciences, Hyderabad 500082, India
Arfa Banu Khan
Affiliation:
Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Belgaum 590010, India
Robert Mathew
Affiliation:
Department of Neurology, Government Medical College, Alleppey 688005, India
P.S. Mathuranath
Affiliation:
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, India
Ramsekhar Menon
Affiliation:
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, India
Ranita Nandi
Affiliation:
Apollo Gleneagles Hospital, Cognitive Neurology Unit, Kolkata 700097, India
Jwala Narayanan
Affiliation:
Department of Neurology, Manipal Hospitals, Bengaluru 560071, India
Ashima Nehra
Affiliation:
Neurosciences Center, All India Institute of Medical Sciences, Delhi 110023, India
M.V Padma
Affiliation:
Neurosciences Center, All India Institute of Medical Sciences, Delhi 110023, India
Apoorva Pauranik
Affiliation:
Department of Neurology, G.M. Medical College, Indore 452001, India
Subasree Ramakrishnan
Affiliation:
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
Prerana Sabnis
Affiliation:
Department of Neurology, Manipal Hospitals, Bengaluru 560071, India Center for Mind/Brain Sciences, University of Trento, Center for Mind/Brain Sciences, Rovereto 38068, Italy
Lekha Sarath
Affiliation:
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, India
Urvashi Shah
Affiliation:
Department of Neurology, King Edward Memorial Hospital, Mumbai 400012, India
Manjari Tripathi
Affiliation:
Neurosciences Center, All India Institute of Medical Sciences, Delhi 110023, India
P.N. Sylaja
Affiliation:
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, India
Ravi Prasad Varma
Affiliation:
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, India
Mansi Verma
Affiliation:
Neurosciences Center, All India Institute of Medical Sciences, Delhi 110023, India
Feba Varghese
Affiliation:
Department of Neurology, National Institute of Mental Health and Neurosciences, Bengaluru 560029, India
*
*Correspondence and reprint requests to: Suvarna Alladi, Professor, Department of Neurology, National Institute of Mental Health and Neurosciences, Hosur Road, Lakkasandra, Bengaluru, Karnataka 560029, India. E-mail: alladisuvarna@hotmail.com

Abstract

Objectives:

While the burden of dementia is increasing in low- and middle-income countries, there is a low rate of diagnosis and paucity of research in these regions. A major challenge to study dementia is the limited availability of standardised diagnostic tools for use in populations with linguistic and educational diversity. The objectives of the study were to develop a standardised and comprehensive neurocognitive test battery to diagnose dementia and mild cognitive impairment (MCI) due to varied etiologies, across different languages and educational levels in India, to facilitate research efforts in diverse settings.

Methods:

A multidisciplinary expert group formed by Indian Council of Medical Research (ICMR) collaborated towards adapting and validating a neurocognitive test battery, that is, the ICMR Neurocognitive Tool Box (ICMR-NCTB) in five Indian languages (Hindi, Bengali, Telugu, Kannada, and Malayalam), for illiterates and literates, to standardise diagnosis of dementia and MCI in India.

Results:

Following a review of existing international and national efforts at standardising dementia diagnosis, the ICMR-NCTB was developed and adapted to the Indian setting of sociolinguistic diversity. The battery consisted of tests of cognition, behaviour, and functional activities. A uniform protocol for diagnosis of normal cognition, MCI, and dementia due to neurodegenerative diseases and stroke was followed in six centres. A systematic plan for validating the ICMR-NCTB and establishing cut-off values in a diverse multicentric cohort was developed.

Conclusions:

A key outcome was the development of a comprehensive diagnostic tool for diagnosis of dementia and MCI due to varied etiologies, in the diverse socio-demographic setting of India.

Type
Regular Research
Copyright
Copyright © INS. Published by Cambridge University Press, 2019 

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